Active NPI
Susan Jean Kingsbury, LMP
- Specialist
- Everett, WA
National Provider Identifier
1861672602
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- MA00024631
- Practice address
- 14022 Meridian Ave S
Everett, WA 98208-6943 - Phone
- (206) 300-6877
- Fax
- (425) 743-2899
- NPI assigned
- Nov 9, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | MA00024631 | WA | Primary |
Addresses
Primary practice location
14022 Meridian Ave S
Everett, WA 98208-6943
Mailing address
14022 Meridian Ave South
Everett, WA 98208-6943
Phone (206) 300-6877
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MA00024631 | WA | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1194566400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1194566400000",
"number": "1861672602",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14022 MERIDIAN AVE SOUTH",
"city": "EVERETT",
"state": "WA",
"postal_code": "982086943",
"telephone_number": "206-300-6877",
"fax_number": "425-743-2899"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14022 MERIDIAN AVE S",
"city": "EVERETT",
"state": "WA",
"postal_code": "982086943",
"telephone_number": "206-300-6877",
"fax_number": "425-743-2899"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KINGSBURY",
"first_name": "SUSAN",
"middle_name": "JEAN",
"name_prefix": "Ms.",
"credential": "LMP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-11-09",
"last_updated": "2007-11-09",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "WA",
"license": "MA00024631",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Everett, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.